北京医改对某医院内科和外科患者住院费用影响的研究  

Study on the influence of Beijing Medical Reform on the hospitalization expenses of medical and surgical patients in a hospital

作　　者：肖久庆 李艺 孔国书 黎蔺娴 段晖[1] Xiao Jiuqing;Li Yi;Kong Guoshu;Li Linxian;Duan Hui(School of Public Administration and Policy,Renmin University of China,Beijing 100872,China;Tongliao Administration Institute,Tongliao 028000,China)

机构地区：[1]中国人民大学公共管理学院,北京100872 [2]通辽行政学院,内蒙古自治区通辽市028000

出　　处：《中华医院管理杂志》2021年第3期257-260,共4页Chinese Journal of Hospital Administration

基　　金：中国人民大学2019年度拔尖创新人才培育资助计划(2019);北京市优秀人才青年骨干个人项目(2018000021469G214)。

摘　　要：目的:分析北京市医药卫生体制改革对某医院内、外科住院患者费用的影响,为医院探索患者费用控制路径提供参考。方法:选取北京市某医院2016年6月至2019年12月的内、外科住院患者费用数据,采用断点回归方法分析两次改革(即医药分开综合改革和医耗联动综合改革)对内、外科住院患者费用水平、药品和耗材费用结构产生的影响。结果:医药分开综合改革和医耗联动综合改革控制了住院费用的过快上涨,降低了药占比和耗占比。其中,改革对内科的总费用控制效果优于外科。对内科而言,医药分开改革对药占比的作用力度更大;而对外科而言,两次改革均有效降低了耗占比,药占比逐步下降。结论:两次改革有效控制了住院费用增长趋势,并使得住院患者的药品、耗材费用结构发生了改变。Objective To analyze the impact of Beijing Medical Reform on inpatient costs of medical and surgical patients in a hospital,and to provide reference for the hospital to explore the path of patient cost control.Methods Based on the data of medical and surgical inpatients′expenses from June 2016 to December 2019 in a hospital in Beijing,breakpoint regression method was used to analyze the impact of the two reforms(namely the comprehensive reform of separation of medicine and pharmacy and the comprehensive reform of medical consumption linkage)on the level of medical and surgical inpatients′expenses and the cost structure of drugs and consumables.Results The two reforms controlled the rapid rise of hospitalization expenses and reduced the proportion of drugs and medical consumption.The effect of the reforms on the total cost control of internal medical patients was better than that of surgical patients.For internal medical patients,the reform of separation of medicine and pharmacy played a greater role in the proportion of medicine;For surgical patients,the two reforms had effectively reduced the proportion of consumables,and the proportion of drugs had gradually decreased.Conclusions The two reforms have effectively controlled the growth trend of hospitalization expenses,and changed the cost structure of drugs and consumables.

关 键 词：医院费用 医药卫生体制改革 费用控制 断点回归 北京 

分 类 号：R197.1[医药卫生—卫生事业管理]